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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

93602180

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Theodore RooseveltRobinson Sex Male

Date of Birth October 9, 1906 Place of Birth Parkers CoveCounty of Annapolis

Name of Father Walter Robinson MAIDEN NAME of Mother Eva Wiles

Residence of Father when child was born Parker's Cove Present address of Father Parker's Cove

Occupation of Father at Birth of child Fishing Place of birth of Father Parker's Cove

Race English Name and present address of Physician in attendance at birth Dr. F.F. Smith

Signature of Applicant Theodore Roosevelt Robinson Address of Applicant Parker's Cove Date 2 March 1926

Relationship of Applicant to child self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Theodore RooseveltRobinson

Born at Parkers Cove in the County of Annapolis

That Theodore RooseveltRobinson Whose Birth is sought to be registered was

born at Parkers Cove Annapolis County on October 9, 1906

My knowledge of the fact and date of such Birth is based on the following Circumstances:

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